Search Our Site

The Plastic Surgery Taboo: Liposuction For Size 2

I live in Miami, where I know people who spend $12,000 on nose jobs (not so they can smell better), $9,000 on boob jobs (not so they can nurse their babies better) and $5,000 on Invisalign (not so they can eat or speak better). But the minute I told a few friends I was having liposuction, you’d think I’d suggested we kill all Labrador retrievers. “What are you, absolutely insane?” said one, insisting that my idea to suck any more fat out of my size 2 frame rendered me officially unhinged.

“I don’t know where this is coming from, but you should probably go see someone. I think there’s a deeper issue here,” offered up a well-meaning colleague. “You’re kind of making me feel bad about where humankind is headed,” said another, at which point I stopped sharing my plans to turn my thighs and rear into minutely slimmer, more finely tuned versions of themselves. I decided to do it quietly and discreetly, and cry “Spanx and no carbs” should anyone notice a markedly slimmer me (which, even prior to surgery, my doctor insisted they wouldn’t).

In locker rooms all over South Beach, I’ve watched women brazenly volunteer to whip off their bras and show curious (female) strangers their doctor’s excellent work. And I hear that women in Iran keep bandages on their rhinoplastied noses for weeks or even months after it’s necessary, because those elective procedures are considered the ultimate status symbol. Yet here, with my own admittedly minor ambition to tweak my body a tad, I felt like I’d wandered into the last remaining bastion of shameful cosmetic surgery. Thankfully, there were plenty who disagreed.

“The body remembers how many fat cells it has,” explains Bay Harbour Islands-based Dr. Ary Krau, MD, with whom I chatted about the subject. “If someone is heavy, gets liposuction and doesn’t change their lifestyle, that fat will come back and park in different places. The thinner patient is actually ideal, because you don’t notice when those few ounces of fat settle somewhere else.”

And as Dr. Randy Miller, MD—a cosmetic and reconstructive surgeon at The Miami Institute for Age Management—points out, “When you have your breasts or nose done, they’re something other people are of course going to see. But maybe the liposuction patients who just want a little bit of fatty tissue removed are coming at the world of plastic surgery from a different psychological perspective. They’re really fine-tuning it for them, not for somebody else.”

While that’s exactly how I felt, I wasn’t immune to what I sensed was a serious social stigma. How would I explain what I was doing to friends who weigh more than me? While I know plenty of women whose breast augmentations never left me feeling insecure, I knew that somehow lipo was different. It was a provocative pool I didn’t want to dip my toe into, so I held off. In fact, I let a year lapse between consults with my doctor, Adam Rubinstein, MD, of Turnberry Plastic Surgery. I dieted, juice-fasted and hired two personal trainers— none of which put a significant, permanent dent in the small outer-thigh bulge I wanted to erase—before taking the plunge.

“I didn’t think you were crazy,” says Rubinstein, when I speak to him more than a year after my surgery (which, by the way, went exactly as I’d hoped, even though it left me only one pound lighter on the scale). “Especially in Miami, we see a lot of young, thin, healthy women who are in really good shape but have one or two little spots that won’t budge. Look, I’m not in the business of need. Nobody needs what I do. It’s about if you want something, if it’s a realistic result you want to achieve, if we can do it safely and if you’ll be happy when you get there.” Of the approximately 200 liposuctions he performs every year, he says I was one of just two or three smaller-sized women looking to thin out their size 2 thighs. The other dozen or so size 0 to 4s came in to obliterate their muffin tops—the bit of excess fat around the hips that sometimes rises up over a waistband. “Lowrise jeans were good for business,” he laughs.

All jokes aside, he says he turns down his fair share of low-weight cases, and stresses the importance of choosing a doctor with hospital privileges who is certified by The American Board of Plastic Surgery. “If you are already thin and don’t have an appreciable amount of fat, it’s possible to remove that layer that we all need to have natural-looking skin. In that case, I’ll say, ‘Look, this is Miami, if you go around, you’ll find a doctor to take your money and do the surgery. But it’s not going to be me.’”

Marco Borges, the South Beach-based celebrity trainer and author of Power Moves, is not a fan of surgical shortcuts. He says choosing liposuction over diet and fitness is “treating the symptoms, not the disease,” which leads to “going back for a little more and a little more—a systemic problem that never cures the real issue.” Borges brings up the notions of needless risk and surgeries gone wrong (such as the death of Kanye West’s mother), and insists he can’t imagine a size 0 or 2 having liposuction for reasons other than insecurity or a bigger societal problem. “We’re living in the era of instant gratification, where everyone wants everything right now, this second,” he explains. “But that’s why so many people are going bankrupt and losing their homes these days—they didn’t think things out carefully and wound up in a jam.”

I knew I was neither looking for a quick fix (I work out religiously six or seven days a week) nor body-dysmorphic (my perceived imperfections never interfered with my ability to function—only my ability to accept myself in liquid leggings). Dr. Eva Ritvo, who coauthored The Beauty Prescription and serves as vice chair of the University of Miami’s department of psychiatry and behavioral sciences, understands. She herself is a size 4 who has had liposuction, and sees the phenomenon for what it is: “Plastic surgery can be helpful and wonderful and enhance your quality of life. But even when a doctor tells you it’s nothing and it’s the smallest case he’s ever done, you don’t want this to be your way of feeling better in the world. Because it’s far more traumatic than you think. It really, really hurts! Oh, does it hurt.”